A bright young mind behind medical oncology

Dr Keo Tabane, a specialist physician based at the Sandton Oncology Centre in Johannesburg, is one of just a few medical oncologists in the country. We chatted to her about what her job entails.

Keo Tabane (aged 41 in 2018) grew up in the village of Hebron, just north of Pretoria. From the tender age of four, Keo insisted on coming along to the school at which her mother worked as a school principal, and soon she was joining the older children in their classes.

This small show of determination marked the start of a career that broke new ground when the bright, bookish young girl grew up to become South Africa’s very first black medical oncologist. We caught up with her in 2018, to learn more about her work.

What is medical oncology?

Medical oncology refers to the use of drugs to manage cancer, be it tablets like hormone blockers, chemotherapy or immunotherapy, through which we try to boost one’s immune system to fight a cancer. Not everybody needs medical treatment, cases vary depending on the clinical prognosis and the patient’s wishes.

What do medical oncologists do?

Well, first you must be a specialist physician in internal medicine, before super-specialising in medical oncology. Medical oncologists then evaluate the particulars of a case to make a proper diagnosis. We advise on what direction the treatment ought to take and then explain the rationale for that choice. We help patients understand what they can expect as far as side-effects go, and how the disease will affect them in the short- and long-term.

Do you see any trends in cancer prevalence in South Africa?

I'm noticing more young people are getting cancer. Traditionally we thought that age was a bigger risk factor, but now we're seeing young people in their late twenties, thirties and forties getting it, so there must be a growing risk factor that many of these people have in common.

How should you change your lifestyle to reduce cancer risk?

We know that obesity is linked to certain cancers, and being lean lowers that risk. So good nutrition is important. Don’t smoke, don’t drink and get enough exercise. It’s a change of lifestyle, but at the end of the day, people need to make personal choices based on the information that is available.

How do these choices affect treatment of the disease?

Because cancer is complex and multifactorial, treatment needs to be holistic. It's not just about treating the cancer, but treating all that makes up the person – be it physical, nutritional, spiritual or psychosocial.

Cancer also needs to be treated within the context of someone's life, and not at the expense of their quality of life. Otherwise we’re all just chasing the cancer, and living from scan to scan and blood test to blood test. In the meanwhile, other aspects of the patient’s life, like their relationships, may suffer. So even if one gets to live longer because of the treatments, they haven't really lived longer, they’ve just existed for a longer time – and that defeats the purpose.

You’re a mom of two – has motherhood changed your own approach to risk?

I pray that I’m healthy enough to see my kids grow up and become independent! I never used to exercise much, but now I exercise because I want to be well, for longer. So I have a personal trainer who comes to my house, because if there's not someone knocking at my door at 05:00 and forcing me to exercise, I might find excuses not to. I have also taken up swimming lessons once a week, because I can’t swim! I pay my trainers in advance, so I can’t get out of it. That’s what works for me.

What are your top tips for cancer patients?

Firstly, you need to discuss the information you’ve learnt from your online searches with your oncologist, so they can place it in the correct context and clear up any misconceptions. There's a lot of information available, especially online, which can be confusing. It’s good to read up on the disease and try to understand it, but it's very easy to read things that are not relevant to your case. So bring what you’ve read to your oncologist and let them explain it.

And then, don’t try do it alone – accept all the help you can. I find often that people who are very independent struggle to accept support from others. It’s the small things, like being driven to and collected from chemo appointments and having people prepare meals for you. The cancer journey can take a lot out of you, so lean on your support system and allow people to love you and care for you

What do you love most about your job?

I think sometimes that oncology is clouded in darkness – people think it's all doom and gloom, but it's not. There are patients who do well after treatment. I especially love it when I treat young women and when they later have children, they come to tell me they are well and show me their babies. It’s a big thing, because people always worry about their fertility after treatment. And often a child signifies so much more to them than just a baby – it signifies a renewal of their own life. Those cases are the best!

Dr Keo Tabane believes communication is key to a good patient-doctor relationship, and that all professionals can benefit from more training in it.

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